Pain intensity and cervical range of motion in women with myofascial pain treated with acupuncture and electroacupuncture: a double-blinded, randomized clinical trial

BACKGROUND: Acupuncture stimulates points on the body, influencing the perception of myofascial pain or altering physiologic functions. OBJECTIVE: The aim was to evaluate the effect of electroacupuncture (EAC) and acupuncture (AC) for myofascial pain of the upper trapezius and cervical range of motion, using SHAM acupuncture as control. METHOD: Sixty women presenting at least one trigger point at the upper trapezius and local or referred pain for more than six months were randomized into EAC, AC, and SHAM groups. Eight sessions were scheduled and a follow-up was conducted after 28 days. The Visual Analog Scale assessed the intensity of local and general pain. A fleximeter assessed cervical movements. Data were analyzed using paired t or Wilcoxon's tests, ANOVA or Friedman or Kruskal-Wallis tests and Pearson's correlation (α=0.05). RESULTS: There was reduction in general pain in the EAC and AC groups after eight sessions (P<0.001). A significant decrease in pain intensity occurred for the right trapezius in all groups and for the left trapezius in the EAC and AC groups. Intergroup comparisons showed improvement in general pain in the EAC and AC groups and in local pain intensity in the EAC group (P<0.05), which showed an increase in left rotation (P=0.049). The AC group showed increases in inclination (P=0.005) sustained until follow-up and rotation to the right (P=0.032). CONCLUSION : EAC and AC were effective in reducing the pain intensity compared with SHAM. EAC was better than AC for local pain relief. These treatments can assist in increasing cervical range of motion, albeit subtly. .

Efficacy of electroacupuncture for myofascial pain in the upper trapezius muscle: a case series / Eficácia da eletroacupuntura para dor miofascial do músculo trapézio: uma série de casos

BACKGROUND: Electroacupunture (EA) includes the passage of an electrical current through the acupuncture needle and is commonly used for pain relief. OBJECTIVE: To evaluate the EA treatment effects for myofascial pain in the upper trapezius muscle. METHODS: Twenty women aged ranging from 18 to 40 years (mean=24.95; SD=5.88 years), with a body mass index ranging from 19 to 25 kg/m2 (mean=22.33; SD=0.56 kg/m2), with regular menstrual cycles controlled by oral contraceptive, local or referred pain for more than six months and at least one myofascial trigger point in the upper trapezius participated in this study. The participants received a total of nine EA sessions over five weeks. The needles were inserted at the accupoints GB20, GB21, LV3, LI4, and at “ashi” points. A mixed current of 2 Hz and 100 Hz was applied alternatively every 5 seconds for 30 minutes. The outcomes were pain intensity measured by the visual analogue scale (VAS), pressure pain threshold (PPT) measured by an algometer, electromyography (EMG) and quality of life measured by the SF-36 questionnaire. Inter-occurrences between sessions were monitored. Paired t-test, Wilcoxon test, and repeated measure analysis of variance (ANOVA) having Tukey-Kramer as post-hoc tests were used. RESULTS: Significant improvement in pain intensity and in PPT occurred after treatment (P<0.0001). EMG of the right trapezius during contraction increased significantly, suggesting muscle function enhancement; the quality of life improved, related to physical components of the SF-36 (P<0.05). CONCLUSION: The EA showed to be a reliable method for myofascial pain relief. Large randomized blinded controlled trials might be carried out to confirm these results. Article registered in the Registro Brasileiro de Ensaios Clínicos under number RBR-4hb6f6.

CONTEXTUALIZAÇÃO: A eletroacupuntura (EA) inclui a passagem de uma corrente elétrica pela agulha de acupuntura e é comumente utilizada para aliviar a dor. OBJETIVO: Avaliar o efeito da EA no tratamento da dor miofascial do músculo trapézio superior. MÉTODOS: Participaram 20 voluntárias com idade entre 18 e 40 anos (24,95±5,88 anos), índice de massa corpórea entre 19 e 25 kg/m2 (22,33±0,56 kg/m2), ciclo menstrual regulado por anticoncepcionais, dor por mais de seis meses no trapézio superior, com pelo menos um ponto gatilho miofascial. Nove sessões de EA foram agendadas, sendo duas por semana. As agulhas foram inseridas nos pontos VB20, VB21, F3, IG4 e em pontos ashi. Aplicou-se uma corrente alternada de 2 Hz e 100 Hz a cada 5 segundos durante 30 minutos. Avaliou-se a eficácia do tratamento quantificando a intensidade da dor com a Escala Visual Analógica (EVA); o limiar de dor à pressão (LDP), com algômetro digital, eletromiografia (EMG) e com o questionário de qualidade de vida SF-36. Possíveis fatores influenciadores entre as sessões foram monitorados. Aplicaram-se os testes t pareado, Wilcoxon e análise de variância com medidas repetidas (ANOVA) e, como post-hoc, o teste de Tukey-Kramer. RESULTADO: Após o tratamento, houve melhora na intensidade da dor e no LDP (P<0,0001). A EMG no trapézio direito, durante a contração, aumentou significativamente, sugerindo melhora da função muscular. A qualidade de vida melhorou considerando os componentes físicos do SF-36 (P<0,05). CONCLUSÃO: A EA mostrou-se confiável no alívio da dor miofascial. Estudos randomizados, cegos e controlados devem ser realizados para confirmar esses resultados. Artigo registrado no Registro Brasileiro de Ensaios Clínicos sob o número RBR-4hb6f6.